Postpartum cardiovascular management in a 43-year-old woman with severe preeclampsia and pre-existing patent ductus arteriosus and aortic valve insufficiency and dilation: A case report

Authors

Giovanni Paolella, Advocate Health - MidwestFollow
Viktoriya Bikeyeva, Advocate Health - MidwestFollow
Andrii Labchuk, Advocate Health - MidwestFollow
Katarzyna Mikrut, Advocate Health - MidwestFollow

Recommended Citation

Paolella G, Bikeyeva V, Labchuk A, Mikrut K. Postpartum cardiovascular management in a 43-year-old woman with severe preeclampsia and pre-existing patent ductus arteriosus and aortic valve insufficiency and dilation: a case report. Presented at: 9th International Congress on Cardiac Problems in Pregnancy; April 2025; Vienna, Austria.

Affiliations

Advocate Lutheran General Hospital

Presentation Notes

Presented at: 9th International Congress on Cardiac Problems in Pregnancy

Abstract

Preeclampsia is a common complication in pregnancy that can significantly affect maternal cardiovascular health, especially in patients with pre-existing heart conditions. We present a complex case of a 43-year-old-woman with severe preeclampsia and a history of patent ductus arteriosus, mild aortic valve insufficiency (AI), and aortic root dilation. The purpose is to highlight the cardiovascular risks and management strategies in the postpartum period. A review of the patient’s medical chart was conducted. Diagnostic workup included electrocardiogram (EKG), transthoracic echocardiography (TTE), and computed tomography angiography (CTA). A multidisciplinary care included obstetrics and gynecology, maternal fetal medicine, and obstetric cardiology. On the third postoperative day, after undergoing a scheduled cesarean section for worsening preeclampsia, the patient developed hypertension, severe chest pain radiating to her back, and lower extremity edema. EKG was non-ischemic, and troponin was normal. CTA ruled out aortic dissection while TTE revealed a newly reduced left ventricular ejection fraction (LVEF) to 43%, worsening AI, and stable aortic root dilation (3.9 cm). The patient’s blood pressure was successfully managed with metoprolol and enalapril and received diuresis with furosemide. At 4-week follow-up, repeat TTE remained stable, and patient was subsequently scheduled for further workup with cardiac MRI. This case underscores the importance of vigilant cardiovascular monitoring in the postpartum period, particularly in patients with pre-existing cardiovascular disease and preeclampsia. Early intervention and a multidisciplinary approach are essential for managing heart failure, aortic root dilation, and blood pressure in these high-risk patients, helping to prevent severe cardiovascular complications.

Type

Oral/Podium Presentation